Access to antiviral drugs for treating HCV for HIV-positive patients in Russia: results and recommendations of the registration, policy and procurement analysis Babikhina Ksenia «Treatment Preparedness Coalition» office@itpcru.org itpcru.org AIDS 2016 | 18-22 July 2016 | Durban, South Africa
• Monitoring of drug procurement since 2010, HCV procurement since 2012 • Coverage of the whole country (85 regions (entities) in Russian Federation) • Around 5000 tenders annually • Using specialized personnel for analysis the monitoring’s results • The results are presented at national-level conferences • Annual reports
HCV. The purposes • Understand how many people can receive HCV treatment; • How much money is spent on purchasing HCV; • Which drugs are procured and which quantities; • Compare with the international recommendation; • Develop recommendation for improving the HCV treatment landscape.
Prevalence of chronic hepatitis C in Russia, 2015 5 million Expert estimates - at least 5 million people with HCV Officially registered - 600 000 people Сo-infected with HIV and HCV - at least 200 000 people Total number of patients who could receive a therapy 600 000 for treating HCV is 5 000 – 10 000 people Less than 1 % of the total estimated number of people with 200 000 HCV 2.5 % co-infected patients
Registered drugs • Data of the website grls.rosminzdrav.ru to HCV drugs registered in Russia in 2015: INN Note Peg-inf 2a («Pegasys») Essential Medicines List /Decree 1438 PegInf 2b («PegIntron», «PegAltevir») Essential Medicines List /Decree 1438 CePegInf 2b («Algeron») Essential Medicines List Simeprevir («Sovriad»/ «Olysio») Essential Medicines List (included in 2016) Daclatasvir («Daklinza») registered in 2015 Asunaprevir («Sunvepra») registered in 2015 Ombitasvir/paritaprevir/ritonavir+Dasabuvir registered in 2015 («Viekira Pak») Sofosbuvir («Sovaldi») registered in 2016 Narlaprevir («Narlaprevir») registered in 2016 Telaprevir («Incivo») Lists of Essential Medicines in Russia (excluded in 2016) Boceprevir («Victrelis») registered in 2013
Metodology www.zakupki.gov.ru List of registered drugs 874 contracts concluded in 2015 • 3 INN for PegINF • 6 INN for DAAs Treatment duration INN 48 weeks Ce/PEG-INF SMV, TPV, 3D 12 weeks BOC 44 weeks (according to Russian recommendation) 24 weeks DCV, ASV
Monitoring and analysis results • Total sum of the contracts = ~42 mln $ Total number of patients: 5 100-9 300 DAAs patients ~1 000 PEG-INF patients ~4100 - 8200 Courses 18,5% 81,5% PEG-INF DAAs
Treatment regimens in Russia 2015 Russian guidelines EASL/AASLD = 17,6%
The price for the treatment course of DAAs 2016 INN average weighted price per average weighted price per course, $ pack, $ Sofosbuvir 3 192 12 weeks – 9 576 3D 4 700 12 weeks – 14 100 Daclatasvir 1 860 12 weeks – 5 580 24 weeks - 11 160 Asunaprevir 190 24 weeks – 1 140 Simeprevir 3 400 12 weeks – 10 200 Boceprevir 1 190 44 weeks (Russian recommendation) – 13 090 Narlaprevir - -
Trend in procurement value of DAAs 2013-2016 1800 1600 1400 1200 1000 800 600 400 200 0 2013 2014 2015 Jan'16-Jun'16 Number of patients
Conclusions 1. The majority of HIV/HCV coinfected patients have still receive PEG-IFN-based therapy 2. None of the DAAs are included in Decree No 1438 3. Sofosbuvir/ledipasvir is still not registered in Russia 4. High prices of DAAs – range of 10,000 – 15,000 USD 5. Clear trend towards DAAs 6. Sofosbuvir and several inf-free regimens were registered in Russia 2015-2016 7. Launching regional programmes for treating HCV Recommendation 1. Update the regulatory framework in the field of HCV to include DAAs (SOF+DCV, SOF+SIM, 3D, SOF/LDV etc) 2. Include DAAs in the Essential Medicines List and Decree No 1438 for federally funded 3. Price reduction on DAAs, including opportunities provided by flexibilities of TRIPS
Recommend
More recommend
